Intrathyroidal parathyroid glands can be a cause of failed cervical exploration for hyperparathyroidism

BACKGROUND: The incidence of intrathyroidal parathyroid glands remains controversial. The purpose of this study was to determine the incidence in a series of patients with hyperparathyroidism. METHODS: Three hundred nine patients underwent parathyroidectomy. Patients were divided into two groups: uniglandular disease versus hyperplasia. RESULTS: Eighteen of 309 patients (6%) had abnormal intrathyroidal parathyroid glands. The incidence was 3% (7 of 222) in patients with uniglandular disease versus 15% (11 of 73) in those with hyperplasia. With a mean follow-up of 54 months, 12 patients are eucalcemic, 5 have persistent hypocalcemia, and 1 has recurrent hypercalcemia. There were no recurrent laryngeal nerve injuries. CONCLUSIONS: These data suggest that an intrathyroidal adenoma is an uncommon cause of failure, whereas abnormal intrathyroidal parathyroid tissue may be a more common cause of failure in patients with hyperplasia.     

Differential partitioning of tRNAs between micellar and aqueous phases: a convenient gel filtration method for separation of tRNAs

A case of Blue Rubber Bleb Nevus in a 11 year-old boy is reported. The patient exhibited characteristic hemangiomas of the skin and gastrointestinal tract with an iron deficiency anemia. Historical, clinical, pathological, and surgical features of the condition are discussed. Value of fibroscopic examination in delineation of the cause of persistent gastrointestinal bleeding is pointed out.     

The artificial heart. Progress and promise

A multidisciplinary group has designed, fabricated, and evaluated an artificial heart. The heart consists of two smooth-surfaced sac-type pumps, two pneumatic power units, and an electronic control system. The artificial heart has been employed in 22 calves. A variety of problems have been encountered and overcome and a significant improvement in pump design has been made. As a result, a gradual increase in survival times has occurred. The last two calves in which the heart was tested lived for 60 and 42 days respectively. These animals ate well and gained weight. The ability of the control system to balance the output of the two pumps over long periods of time and to automatically increase cardiac output with treadmill exercise has been confirmed. No insurmountable problems in the development of the artificial heart have been identified. The date that an artificial heart will be available for clinical use depends on the availability of funds and on the tenacity of the investigators.     

Antibody-induced antigen redistribution and shedding from human breast cancer cells

Cell surface antigens of human breast cancer cells undergo a rapid redistribution when bound by antibodies from cancer patients. The subsequent shedding of these antigen-antibody complexes and free antigen may be instrumental in tumor survival.     

Ouabain-sensitive ion fluxes in the smooth muscle of the guinea-pig's taenia coli

1. Tissues with raised intracellular Na levels, produced by incubation in K-free media, were used throughout. The uptake of 42K by these Na-loaded tissues was followed for 10 min in the presence and absence of 1-37 X 10(-4) M ouabain, this being sufficient to inhibit Na pumping maximally. Subtraction of the uptake seen in the presence from that seen in the absence of ouabain gave estimates of the pumped ouabain-sensitive K uptake. 2. In Na-free (MgCl2) medium this depended on the [K]0 in a sigmoidal fashion with a half maximal [K]0 for activation of some 4mM. The maximal uptake of K was 3 m-mole/kg.min corresponding to a transmembrane flux of some 12-5 p-mole. cm-2.sec-1. 3. In the presence of Na the K activation curve became more obviously sigmoid and higher concentrations of K were needed to achieve a given active K influx. The results were well fitted by assuming that Na and K competed for two identical, non-interacting sites on the external pump face. 4. Addition of K during the efflux of 24Na into a Na-free (MgCl2) medium led to an increased rate of tracer loss. The magnitude of this increase depended on the [K] used in a hyperbolic fashion and it was abolished by addition of ouabain. The [K] causing half-maximal activation of ouabain-sensitive Na efflux was in the order of 1-2 mM. 5. When the [K] in the uptake media was 1-5 mM; Na, Li, Rb and Cs all inhibited ouabain-sensitive K uptake, the order of effectiveness being Rb greater than Cs greater than Na greater than Li. With a E1TKA10 OF 0-15 MM low concentrations of Cs and Rb were shown to stimulate K uptake. Such an effect is predicted by assuming two ion binding sites on the pump's outer face, and that the pump can translocate mixtures of K and either Rb or Cs...     

Studies on the role of cephalic-vagal stimulation in the acid secretory response to eating in normal human subjects

These experiments were performed to determine the importance of cephalic-vagal stimulation in the acid secretory response to eating in normal human subjects. Cephalic stimulation was induced by a modified sham feeding (MSF) technique, during which subjects chewed and expectorated appetizing food. The response to MSF was compared with that to gastric distention with 600 ml NaCl, glucose, or food. In addition, we measured the extent to which cephalic stimulation augments acid secretion that has been stimulated simultaneously by these other mechanisms. Our conclusions are as follows: (a) cephalic stimulation accounts for approximately one-third of the acid secreted when all mechanisms act simultaneously (food-distention plus MSF); (b) within the limits imposed by the maximal secretory capacity, the response to MSF is approximately the same, regardless of whether acid secretion is otherwise unstimulated or is stimulated simultaneously by gastric distention with NaCl, glucose, or food; and (c) gastric distention prolongs the response to cephalic stimulation.     

Early diagnosis of pregnancy in general practice

The value of the signs and symptoms of pregnancy and of the pregnancy diagnostic test as predictors of pregnancy was estimated for 1,592 women seen in general practice. The presence of a sign or symptom alone is a poor pointer to a diagnosis of pregnancy. The combination of pairs of features improves the value, the best being breast signs combined with either the presence of signs of pregnancy on vaginal examination or a palpable fundus, both giving predictive values of 0.89. The pregnancy diagnostic test alone, however, had a predictive value of 0.91, a value of 1.00 indicating 100 per cent reliability.